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Non-sarcoidal, non-tuberculoid granuloma in common variable immunodeficiency
M B Abdel-Naser1, U Wollina, M A El Hefnawi
1Department of Dermatology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. abdelnasermb@yahoo.com
Journal of Drugs in Dermatology : JDD
|May 6, 2006
Summary
This case report details a patient with common variable immunodeficiency (CVID) presenting with unusual non-sarcoidal granulomas. The findings highlight a rare granuloma annulare manifestation in CVID patients.
Area of Science:
- Dermatology
- Immunology
- Pathology
Background:
- Common variable immunodeficiency (CVID) typically presents with sarcoidal or tuberculoid granulomas.
- This report focuses on an atypical presentation of CVID with non-sarcoidal, non-tuberculoid granulomas.
Observation:
- A 29-year-old male with CVID exhibited a vitiliginous patch, recurrent warts, chronic diarrhea, recurrent infections, subcutaneous nodules, and rheumatoid-like arthritis.
- Histopathology of subcutaneous nodules revealed fibrinoid degeneration of collagen surrounded by histiocytes, consistent with granuloma annulare.
Findings:
- The patient had significantly reduced serum immunoglobulins (IgG, IgA, IgM) and deficient T cell function.
- While infections and warts responded to immunoglobulin therapy, and vitiligo to PUVA, the subcutaneous nodules persisted.
Implications:
- This case expands the spectrum of cutaneous manifestations in CVID, presenting granuloma annulare as a rare possibility.
- It underscores the importance of considering diverse dermatological presentations in immunodeficient patients.